Pertussis post-exposure prophylaxis among household contacts: a cost-utility analysis.

BACKGROUND: Recent pertussis outbreaks have prompted re-examination of post-exposure prophylaxis (PEP) strategies, when immunization is not immediately protective. Chemoprophylaxis is recommended to household contacts; however there are concerns of clinical failure and significant adverse events, especially with erythromycin among infants who have the highest disease burden. Newer macrolides offer fewer side effects at higher drug costs. We sought to determine the cost-effectiveness of PEP strategies from the health care payer perspective. METHODS: A Markov model was constructed to examine 4 mutually exclusive strategies: erythromycin, azithromycin, clarithromycin, or no intervention, stratified by age group of contacts ("infant", "child", and "adult"). Transition probabilities, costs and quality-adjusted life years (QALYs) were derived from the literature. Chronic neurologic sequelae were modeled over a lifetime, with costs and QALYs discounted at 5%. Associated health outcomes and costs were compared, and incremental cost-effectiveness ratios (ICER) were calculated in 2012 Canadian dollars. Deterministic and probabilistic sensitivity analyses were performed to evaluate the degree of uncertainty in the results. FINDINGS: Azithromycin offered the highest QALYs in all scenarios. While this was the dominant strategy among infants, it produced an ICER of $16,963 per QALY among children and$2,415 per QALY among adults. Total QALYs with azithromycin were 19.7 for a 5-kg infant, 19.4 for a 10-year-old child, and 18.8 for a 30-year-old adult. The costs of azithromycin PEP among infants, children and adults were $1,976,$132 and $90, respectively. While results were sensitive to changes in PEP effectiveness (11$379 to $59,644), the choice of strategy remained unchanged. INTERPRETATION: Pertussis PEP is a cost-effective strategy compared with no intervention and plays an important role in contact management, potentially in outbreak situations. From a healthcare payer perspective, azithromycin is the optimal strategy among all contact groups

Quantum phases in entropic dynamics

In the Entropic Dynamics framework the dynamics is driven by maximizing entropy subject to appropriate constraints. In this work we bring Entropic Dynamics one step closer to full equivalence with quantum theory by identifying constraints that lead to wave functions that remain single-valued even for multi-valued phases by recognizing the intimate relation between quantum phases, gauge symmetry, and charge quantization.Comment: Presented at MaxEnt 2017, the 37th International Workshop on Bayesian Inference and Maximum Entropy Methods in Science and Engineering (July 9-14, 2017, Jarinu, Brazil

Rotational Dynamics of Organic Cations in CH3NH3PbI3 Perovskite

Methylammonium lead iodide (CH3NH3PbI3) based solar cells have shown impressive power conversion efficiencies of above 20%. However, the microscopic mechanism of the high photovoltaic performance is yet to be fully understood. Particularly, the dynamics of CH3NH3+ cations and their impact on relevant processes such as charge recombination and exciton dissociation are still poorly understood. Here, using elastic and quasi-elastic neutron scattering techniques and group theoretical analysis, we studied rotational modes of the CH3NH3+ cation in CH3NH3PbI3. Our results show that, in the cubic (T > 327K) and tetragonal (165K < T < 327K) phases, the CH3NH3+ ions exhibit four-fold rotational symmetry of the C-N axis (C4) along with three-fold rotation around the C-N axis (C3), while in orthorhombic phase (T < 165K) only C3 rotation is present. Around room temperature, the characteristic relaxation times for the C4 rotation is found to be ps while for the C3 rotation ps. The -dependent rotational relaxation times were fitted with Arrhenius equations to obtain activation energies. Our data show a close correlation between the C4 rotational mode and the temperature dependent dielectric permittivity. Our findings on the rotational dynamics of CH3NH3+ and the associated dipole have important implications on understanding the low exciton binding energy and slow charge recombination rate in CH3NH3PbI3 which are directly relevant for the high solar cell performance

A Study on Reflective Reciprocal Peer Coaching for Pre-service Teachers: Change in Reflectivity

Reflective practice is considered as an effective way for professional development in order to gain awareness of one’s own teaching as well as to compete with the changing needs of the students. Especially in pre-service period, when pre-service teachers work cooperatively with their peers in a reciprocal fashion towards reflectivity, it has a potential to promote advancement in reflective practices and help them focus on the underlying meaning behind their actions. Based on these ideas, this study aimed at engaging pre-service teachers in a reflective reciprocal peer coaching experience and investigating whether such experience caused any changes in their reflectivity. For this purpose, 12 pre-service teachers in a Turkish ELT context participated in the study and a reflective reciprocal peer coaching program was implemented with a training aspect. In a mixed method study design, change in participants’ reflectivity was measured with a profile of reflective thinking attributes scale quantitatively and data were supported qualitatively with reflective diaries, video recordings of post-conference sessions and focus-group interviews. Results of quantitative and qualitative analyses put forward that the pre-service teachers advanced in their reflectivity throughout the reflective reciprocal peer coaching practice and benefited much from this experience before they embark into professional life. This study provides valuable implications to use reflection embedded in a peer coaching program and offers suggestions for teacher educators

The sources of foreign language reading anxiety of students in a Turkish efl context.

Tez (yüksek lisans) - Anadolu ÜniversitesiAnadolu Üniversitesi, Eğitim Bilimleri Enstitüsü, Yabancı Diller Eğitimi Anabilim DalıKayıt no: 337429Kaygının yabancı dil öğreniminde önemli bir rolünün olduğu ve yabancı dil öğrenen öğrencilerin yaşadığı kaygının dil öğrenimlerini nasıl etkilediği son zamanlarda araştırmacıların ilgisini çekmektedir. Araştırmacılar özellikle, kaygının konuşma, dinleme, yazma ve okuma gibi birtakım becerilerin edinimini neden ve nasıl etkilediği üzerinde yoğunlaşmaktadır. Bu beceriler arasında, hakkında çok az araştırma yapılmış olan alanlardan birisi de kaygı ve yabancı dilde okuma arasındaki ilişkidir. Buçalışma, öğrencilerin bakış açısından yabancı dilde okuma kaygısının kaynaklarını bulmayı hedeflemiştir. Bu amaçla, Anadolu Üniversitesi İngiliz Dili ve Eğitimi Bölümü'nde okuyan 50 birinci sınıf öğrencisi denek olarak seçilmiştir. Yabancı dilde okuma kaygısının kaynaklarını bulabilmek için, öncelikle öğrencilerin hissettiği kaygının yabancı dilde okumaya özgü mü yoksa genel dil öğrenimiyle mi ilgili olduğunun bulunması gereklidir. Ölçeğin Türkçe versiyonları kullanılmıştır. Bu ölçekler; öğrencilerin genel dil öğrenme kaygı seviyelerini ölçen FLCAS ve yabancı dilde okuma kaygı seviyelerini ölçen FLRAS'dır. Bu ölçeklerden FLRAS'ın Türkçe versiyonu bulunmadığından, bu ölçek geri çevirme yöntemiyle Türkçe'ye çevrilmiştir. Geçerlik ve güvenirliği ise 332 öğrenci ile yapılan pilot çalışmada temel bileşenler analizi ve varimax rotasyonu tekniği ile Cronbach a katsayısı kullanılarak hesaplanmıştır. Bu çalışmada kullanılan iki ölçek öğrencilere farklı zamanlarda verilmiş ve Pearson product-moment korelasyon analizi sonucunda yabancı dilde okuma kaygısının genel dil öğrenme kaygısı ile alakalı, fakat ondan ayrı bir fenomen olduğu ortaya çıkmıştır. Yabancı dilde okuma kaygısının kaynaklarını bulabilmek içİn çalışmaya katılan öğrencilerden yedi hafta boyunca her hafta günlük tutmaları istenmiştir. Ayrıca, deneklerden %50 si yani 25 öğrenci ile günlüklerin analizlerinden çıkan yabancı dilde okuma kaygısı kaynaklarını desteklemek ve ilave etmek istedikleri herhangi bir şey kalıp kalmadığını anlamak amacıyla görüşmeler yapılmıştır. Bu görüşmeler çözümlenerek, hem öğrencilerin tuttukları günlükler hem de görüşmeler Sabit Karşılaştırma Yöntemi kullanılarak analiz edilmiştir. Analizlerin sonucunda, Türk öğrencilerin, yabancı dilde okuma kaygısına etki eden üç ana kaynak bulunmuştur. Bu kaynaklar; kişisel faktörler, okuma metni ve okuma dersinden dolayı ortaya çıkan kaygılardır. Bu çalışma, yabancı dilde okuma kaygısının ayrı bir fenomen olduğunu ve öğrencilerin hedef dilde okuma yaparken bir takım nedenlerden ötürü kaygı duyduklarını ortaya çıkarmıştır. Son olarak, bir takım çıkarımlar irdelenmiş ve öğrencilerin yabancı dilde okuma kaygılarına ilişkin çeşitli çözüm önerilerinde bulunulmuştur

Dispersion of Axisymmetric Longtudinal Waves in a Pre-Strained Imperfectly Bonded Bi-Layered Hollow Cylinder

This paper studies the dispersion of the axisymmetric longitudinal wave propagation in the pre-strained hollow cylinder consisting of two-layers under the shear-spring type imperfectness of the contact conditions between these layers. The investigations are made within the framework of the piecewise homogeneous body model by utilizing the 3D linearized theory of elastic waves in elastic bodies with initial stresses. It is assumed that the layers of the cylinder are made from compressible hyper-elastic materials and their elasticity relations are given through the harmonic potential. The degree of the mentioned imperfectness is estimated by the shear-spring parameter. Numerical results on the influence of this parameter on the behavior of the dispersion curves related to the fundamental mode are presented and discussed. It is established that the considered type imperfectness of the contact conditions causes two branches of the dispersion curve related to the fundamental mode to appear: the first disappears, but the second approaches the dispersion curve obtained for the perfect interface case by decreasing the shear-spring parameter

Structure-guided design and optimization of small molecules targeting the protein-protein interaction between the von hippel-lindau (VHL) E3 ubiquitin ligase and the hypoxia inducible factor (HIF) alpha subunit with in vitro nanomolar affinities

E3 ubiquitin ligases are attractive targets in the ubiquitin-proteasome system, however, the development of small-molecule ligands has been rewarded with limited success. The von Hippel-Lindau protein (pVHL) is the substrate recognition subunit of the VHL E3 ligase that targets HIF-1α for degradation. We recently reported inhibitors of the pVHL:HIF-1α interaction, however they exhibited moderate potency. Herein, we report the design and optimization, guided by X-ray crystal structures, of a ligand series with nanomolar binding affinities